New Jersey is making great strides in holding down auto insurance costs by capping fees for hundreds of medical procedures covered by personal injury protection, or PIP. But pain management treatments will not be capped. That’s a potentially big mistake, and it worries us.

Pain management is costly. It can include prescriptions for oxycodone, or cortisone injections that cost as much as $30,000 a pop. Spine surgeons, neurologists and anesthesiologists lobbied hard to keep the cap off, arguing that placing limits on what they could charge would chase many practitioners out of the state.

Sen. Joseph Vitale (D-Middlesex), chairman of the Senate health committee, disagrees and with good reason. Pain management not only drives up health care costs, it’s a magnet for fraud. Auto insurers are obligated to pay most of the cost and the consumer is stuck with the tab in higher insurance rates.

Fee caps weed out inappropriate and unnecessary care, he said, and rein in medical practitioners who would exploit the system.

Vitale doesn’t buy the argument that these specialists will flee the state because, even with the caps, New Jersey would still have the highest reimbursement rates in the region.

The need to contain costs has never been greater. New Jersey has the second-highest auto insurance costs in the nation, averaging us about $1,200 a year, second only to Washington, D.C. Our levels of insurance are among the most generous, and our tendency is to use everything we have coming to us. If you’re in an auto accident and you’re covered for 10 sessions of physical therapy, chances are you’ll take all 10.

In the past, some insurance companies would take a loss on the auto side, to keep their homeowner’s insurance customers. With the cost of cleanup after recent catastrophes in the housing market, that’s no longer possible. Meanwhile, policyholders are exhausting their PIP coverage with greater frequency because of the high cost of medical treatment. At that point, their personal health insurance — if they have it — may kick in.

Pain treatment caps “were the caps we wanted most,” said Deana Lykins, president of the Insurance Council of New Jersey.

Chances are slim any changes will be made to the cap proposal now, although public comment is open until April 21. The state is going in the right direction, placing limits on what doctors can charge for other treatments and procedures. In two years, when the fee schedule expires, they should revisit their decision to leave pain management uncapped.